RPM-30-2-Can Do

RPM-30-2-Can Do is a mnemonic device for the criteria used in the START triage system, which is used to sort patients into categories at a mass casualty incident.[1][2][3] The mnemonic is pronounced "R, P, M, thirty, two, can do."

Mnemonic for adult triage

Using the START system, GREEN (MINOR) patients are easily identified by their ability to walk to a designated treatment area when told to do so immediately after the first responders' arrival.[4]

Deceased patients are easily identified by apnea with no return of spontaneous respirations when their airway is repositioned. These patients are triaged BLACK (EXPECTANT/DECEASED).[4]

"RPM-30-2-Can do" helps responders differentiate between the other two triage categories: YELLOW (DELAYED) and RED (IMMEDIATE). "30, 2, Can Do" stands for the criteria that delineate these two categories:

  • Respirations: Is the patient's respiratory rate over or under 30?
  • Perfusion: Is capillary refill over or under 2 seconds?
  • Mental status: Is the patient able to follow simple commands (the patient can do what you ask them to)?

To be triaged YELLOW (DELAYED) , the patient must meet all of these criteria:

R30Respiratory rate is under 30
P2Perfusion is adequate, indicated by capillary refill under 2 seconds.[4]
MCan DoMental status is adequate, indicated by the patient's ability to follow simple commands (the patient can do what they are asked)

If any one of these criteria are not met, the patient is triaged RED (IMMEDIATE).

Inclusion of pediatric criteria

An alternative version of this mnemonic is RPM-30-2-Can Do-15-45. The "15-45" at the end refers to the different respiratory criteria in the pediatric JumpSTART triage system, due to the differences between children's and adults' normal respiratory rates.[5]

In pediatric patients:

  • Children who are breathing under 15 times a minute are RED.[5]
  • Children who are breathing over 45 times a minute are RED.[5]

The remainder of the criteria are the same as those specified in the adult acronym, except that an apneic child is given five assisted ventilations before being triaged Black. A child who starts breathing on their own after five ventilations is triaged RED; a child without spontaneous return of respirations is triaged BLACK.[5]

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See also

References
  1. Kanten, Benjamin S. (April 20, 2013). Do You Know Where to START in a Disaster? (Speech). National Commission on Correctional Health Care Spring Conference on Correctional Health Care, Denver, Colorado. Retrieved February 10, 2016.
  2. Markovchick, Vincent J.; Pons, Peter T.; Bakes, Katherine M.; Buchanan, Jennie A. (2016). Emergency Medicine Secrets (6th ed.). Philadelphia: Elsevier. p. 663. ISBN 978-0-323-35516-2.
  3. Husted, Ernie (April 15, 2011). "Principles of Triage During a Mass Casualty Incident" (PDF). OhioResponds: Emergency Preparedness. Ohio Department of Health, Office of Health Preparedness. pp. 44–49. Retrieved February 9, 2016.
  4. "START Triage Adult Algorithm". Chemical Hazards Emergency Medical Management. United States National Library of Medicine, National Institutes of Health. October 31, 2014. Retrieved February 9, 2016.
  5. "JumpSTART Pediatric Triage Algorithm". Chemical Hazards Emergency Medical Management. United States National Library of Medicine, National Institutes of Health. June 25, 2011. Retrieved February 9, 2016.
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